Diagnosis and assessmentUniversity of North Carolina, Chapel Hill, notes that notExperts are finding they can now reliably diagnose ASD inall children will respond to the same treatment, though.

children from 12 to 18 months old by looking at their socialAdditional studies have underscored that it’s the earliness ofdeficits or repetitive actions. But the trajectory of the disorderthe intervention — not the method itself — that leads to theis unpredictable, says Catherine Lord, PhD, who has studiedpositive outcomes. “There is more than one way to get goodhigh-risk ASD babies from 18 months to 36 months (Journal of

outcomes, and different therapists will gravitate to differentConsulting and Clinical Psychology, Lord, et al. 2012).methods,” she stresses.

“In young children — especially under 2-and-a-half yearsLEAP (Learning Experiences and Alternative Program— we shouldn’t treat it as a lifetime diagnosis. We can offerfor Preschoolers and Their Parents) is another successfulparents some hope that a very young child will move outintervention for young children. This treatment model mixesof the autism spectrum or improve,” says Lord, who directschildren with ASD with typically developing preschool kids inthe Center for Autism and the Developing Brain at the Weillthe classroom. In this way, the ASD child has the opportunityCornell Medical College/Newto learn appropriate languageYork Presbyterian Hospital.

At the same time, sheadds, other children withASD regress — and this canhappen whether or not the

Psychologists need tostress to parents that theand behavior from otherkids who are taught howto interact with them. Thelearning program is designedso kids become engaged withchild receives treatment. Thereasons are unknown, but

One study found that theevaluate the child throughoutthe preschool years.

Psychologists need to adviseautism is suspected.

best LEAP outcomes werelinked to how well the teachercomplied with the protocolparents that the “wait-and-see”approach is not appropriate when autism is suspected, says LauraSchreibman, PhD, a professor at the University of California, SanDiego, who directs the university’s Autism Intervention ResearchProgram. Delaying a diagnosis can mean giving up the significantgains of intervention that have been demonstrated before age 6.

Early intervention can even prevent regression of communicationand social skills in some cases, she says.

Rogers explains that it’s easier to develop comprehensive
treatment approaches for infants and toddlers than for older
children. “This is because they are not as diverse a group
as 10-year-olds,” she says. “We haven’t yet isolated the key
ingredients and variables affecting treatment outcome in older
children who need a more individual approach,” she says.

Intervention for young children

One research-proven intervention for very young children with
ASD is the Early Start Denver Model (ESDM), a structured
teaching and relationship-based approach in the child’s home
that uses play as a learning tool. A randomized, controlled
trial over two years found that children age 18 to 30 months
participating in ESDM significantly improved their IQs, social
interaction and language abilities (Pediatrics, Dawson, et al. 2010).

(Topics in Early ChildhoodSpecial Education, Strain, et al. 2011). Teachers who receivedintensive training and coaching over the two-year studyadhered to the LEAP practices 90 percent of the time. Theirstudents with ASD showed significantly greater improvementson behavioral measures and symptoms than the ASD studentswhose teachers were simply given the LEAP manual to follow.

Properly trained parents can also help infants and toddlers
with autism make gains in areas such as “joint attention,” says
Dawson. Joint attention skills involve sharing through pointing
or coordinating looks, for instance, or sustaining attention
with a parent or an activity. In one study (Journal of Autism
Development Disorder, Kasari, et al. 2010), parents were trained
from once a month to several times a week on how to expand
their children’s interest in play. The quality of the parents’
participation — not the number of training sessions — was
linked to how much progress was made.

Causes: prenatal development factorsResearchers have not yet been able to pinpoint the exact causesof ASD, but they are closer. They do know that autism resultsfrom a genetic mutation in 15 percent to 20 percent of cases.

But environmental factors can combine with and increase aThe children received 20 hours per week of ESDM interventionplus five or more hours of guided care from parents.